Mason Delacroix
The word alcoholic is often associated with negative connotations, and some people may prefer to use different terms to describe themselves or others with alcohol dependence. Some alternatives include teetotaler or teetotaller, which means someone who never drinks alcohol, or sober, which indicates a state of not being drunk. Other terms such as ex-drinker or in recovery are also used by individuals who have quit drinking to describe themselves. From a medical perspective, the term alcohol use disorder is used to describe this condition, emphasizing the objective diagnostic criteria, symptoms, and treatment options associated with it.
| Characteristics | Values |
|---|---|
| Definition | Alcoholism is the continued drinking of alcohol despite it causing problems. It is also referred to as Alcohol Use Disorder (AUD), alcohol dependence, alcohol addiction, or alcohol abuse. |
| Prevalence | As of 2016, the World Health Organization (WHO) estimated there were 283 million people with AUD worldwide. |
| Risk Factors | Genetic and environmental factors, including family history of alcoholism, early age of drinking onset, lack of peer and family support, childhood trauma, and mental health conditions. |
| Health Consequences | Alcohol misuse can damage all organ systems, particularly the brain, heart, liver, pancreas, and immune system. It can also cause trouble sleeping, increased anxiety, and other withdrawal symptoms. |
| Treatment | Evidence-based treatments include behavioral therapies, mutual-support groups, and medications such as naltrexone, acamprosate, and disulfiram. Group therapy and psychotherapy can also help encourage abstinence or reduce alcohol consumption. |
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What You'll Learn
Alcohol use disorder (AUD)
The exact cause of AUD is unknown, but it likely involves neurobiological and epigenetic adaptations in the brain. AUD is associated with long-term alcohol-induced changes in the brain that perpetuate the disorder and make individuals vulnerable to relapse. These changes can cause individuals to crave alcohol, lose control of their drinking, and require larger quantities to achieve the desired effects. AUD is also associated with intense alcohol cravings that drive ongoing consumption. Alcohol affects the release of dopamine in the brain's reward pathway, as well as other reward systems such as the endogenous opioid system and the serotonin system.
The diagnosis of AUD is based on the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) criteria. According to the American Psychiatric Association, a person is diagnosed with AUD if they meet two or more of the eleven criteria within a one-year period. Some of the criteria include consuming alcohol in greater quantities or for longer than intended, unsuccessful attempts to reduce alcohol use, and continued alcohol use despite the negative consequences on social and occupational functioning.
AUD is a treatable disorder, and recovery is achievable through evidence-based treatments. Treatment approaches vary and may include outpatient and/or inpatient care, therapy, support groups, medication, or a combination of these methods. Three medications are currently approved by the U.S. Food and Drug Administration to help reduce drinking and prevent relapse: naltrexone, acamprosate, and disulfiram. These medications are non-addictive and can be used alongside behavioural treatments. Behavioural treatments, such as alcohol counselling and talk therapy, aim to change drinking behaviour and build motivation to abstain from alcohol.
The term "sober" is often associated with an alcoholic who has stopped drinking and is in recovery. Sobriety refers to the state of being sober, which means being free from the influence of alcohol or other intoxicating substances. It implies a return to a clear-minded and rational state, free from the impairing effects of alcohol.
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Alcohol dependence
The development of alcohol dependence is associated with neuroadaptive changes that result from continued alcohol use and abuse. These changes manifest as tolerance and physiological dependence, leading to more frequent and excessive drinking. The fear of experiencing withdrawal symptoms can perpetuate alcohol abuse and contribute to relapse after periods of abstinence. Withdrawal symptoms can include trouble sleeping, shakiness, restlessness, nausea, sweating, a racing heart, dysphoria, malaise, and seizures.
Treatment for AUD includes medication, behavioural therapy, and mutual-support groups. Three medications approved by the U.S. Food and Drug Administration to help reduce drinking and prevent relapse are naltrexone, acamprosate, and disulfiram. Behavioural treatments, such as alcohol counselling and talk therapy, aim to change drinking behaviour and build coping skills.
Genetics play a significant role in AUD risk, with hereditability accounting for approximately 60%. However, like other chronic health conditions, AUD risk is influenced by the interplay between genes and the environment. Parents' drinking patterns may also impact the likelihood of their children developing AUD. Additionally, mental health conditions and a history of trauma are associated with an increased risk of AUD.
To summarise, alcohol dependence or AUD is a medical condition where individuals struggle to control their alcohol consumption despite negative consequences. Treatment options include medication and therapy, and a combination of approaches may be necessary to achieve and maintain recovery. Understanding the risk factors and influences behind AUD can help inform prevention and treatment strategies.
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Alcohol addiction
Genetics play a significant role in the development of AUD, with hereditability accounting for approximately 60%. However, the risk of AUD is also influenced by environmental factors and an individual's life experiences. For example, parents' drinking patterns can impact their children's likelihood of developing AUD. Additionally, mental health conditions such as depression, post-traumatic stress disorder (PTSD), and attention deficit hyperactivity disorder (ADHD) are associated with an increased risk of AUD, and individuals with a history of childhood trauma are also more vulnerable to developing the disorder.
The cycle of alcohol addiction can be understood through changes in three key regions of the brain: the basal ganglia, the extended amygdala, and the prefrontal cortex. Repeated alcohol consumption leads to habit formation and compulsive use, with progressive changes in brain structure and function. When a person with alcohol addiction stops drinking, they experience physical and emotional withdrawal symptoms due to changes in the brain's reward and stress systems. This negative emotional state, known as hyperkatifeia, may drive further alcohol consumption to find relief.
Treatment for AUD includes medication and behavioural therapy, with evidence-based approaches tailored to the individual. Inpatient and outpatient programmes, specialty groups, therapists, and health care providers can provide support. Three medications approved by the U.S. Food and Drug Administration—naltrexone, acamprosate, and disulfiram—are non-addictive options that can be used alone or in combination with behavioural treatments. Behavioural treatments, such as alcohol counselling or talk therapy, aim to change drinking behaviour and build skills to prevent relapse.
While alcohol addiction is a challenging disorder, evidence-based treatments offer hope for recovery. With treatment, many individuals can reduce their alcohol consumption or achieve abstinence. Support is available through various resources, including the SAMHSA National Helpline, which offers free and confidential referrals and information for individuals and families facing substance use disorders.
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Alcoholism
When discussing an individual who struggles with alcohol use and is in recovery, the term "sober" is often used to describe their state of abstinence from alcohol. Sobriety is a critical aspect of an alcoholic's journey, as it signifies their commitment to a life free from the influence of alcohol. This choice to remain sober is a continuous and active process that requires dedication and a conscious effort to avoid relapsing into old patterns of alcohol abuse.
The path to sobriety for an alcoholic often involves a combination of treatment approaches, including medical detoxification, therapy, support groups, and lifestyle changes. Detoxification, or detox, is a critical first step in the recovery process, as it involves clearing the body of alcohol and managing withdrawal symptoms. This process can be dangerous and should be done under medical supervision to ensure safety and comfort. Various therapies, such as cognitive-behavioral therapy and motivational interviewing, can help individuals understand the underlying causes of their addiction and develop strategies to manage triggers and cravings.
Support groups, such as Alcoholics Anonymous (AA), provide a sense of community and offer ongoing encouragement and accountability. These groups often follow a 12-step program that encourages personal inventory, amends, and ongoing sobriety. Lifestyle changes are also crucial, as individuals learn to manage stress, develop new hobbies and interests, and build a supportive social network that aligns with their commitment to sobriety. Maintaining sobriety is a lifelong journey that requires ongoing vigilance and a strong support system.
The term "recovery" is often used to describe the process of an alcoholic achieving and maintaining sobriety. This term encompasses the idea of healing and regaining control over one's life. Recovery is a highly personal journey and can involve different paths and timelines for each individual. It involves not only abstaining from alcohol but also rebuilding one's physical and mental health, relationships, and overall well-being. The recovery process often involves addressing the underlying issues that contributed to alcohol abuse, such as trauma, mental health disorders, or social pressures.
Sobriety and recovery from alcoholism are challenging but achievable goals. With dedication, support, and a comprehensive treatment approach, individuals can break free from the grip of alcohol and rebuild their lives. It is a journey of self-discovery, healing, and empowerment, and each step towards sobriety is a testament to the individual's strength and resilience.
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Treatment and recovery
Alcohol use disorder (AUD) is a medical condition characterised by an inability to stop or control alcohol consumption despite adverse social, occupational, or health consequences. AUD can be mild, moderate, or severe, and is influenced by a combination of genetic and environmental factors. Treatment and recovery from AUD may include:
Inpatient and Outpatient Treatment
Treatment for AUD can be provided on an inpatient or outpatient basis, depending on the severity of the condition. Inpatient treatment typically involves a stay in a residential rehabilitation centre, while outpatient treatment allows the individual to receive treatment while continuing to live at home.
Medication
The U.S. Food and Drug Administration has approved several medications to help reduce alcohol consumption and prevent relapse, including naltrexone, acamprosate, disulfiram, topiramate, and gabapentin. These medications are non-addictive and can be used alone or in combination with other treatments.
Therapy and Counselling
Behavioural treatments, such as therapy and counselling, aim to change drinking behaviour and teach skills for coping with triggers and preventing relapse. Therapy and counselling can be provided by licensed therapists, addiction counsellors, or psychologists.
Support Groups
Support groups, such as Alcoholics Anonymous (AA) and other 12-step programs, provide peer support for individuals quitting or reducing their alcohol consumption. These groups offer a valuable layer of support and can help promote recovery by connecting individuals with others who understand their situation.
Treatment Referral Services
Individuals seeking treatment for AUD can utilise referral services, such as SAMHSA's National Helpline, to find local treatment facilities, support groups, and community-based organisations. These services are typically free, confidential, and available 24/7.
It is important to remember that treatment for AUD should be tailored to the individual, as what works for one person may not work for another. Seeking help from a healthcare provider is an important first step in finding the right treatment and beginning the journey towards recovery.
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Frequently asked questions
Sobriety or sober.
Sobriety is the condition of not having any effects from alcohol and other drugs. It is also considered the natural state of a human being at birth.
Teetotal, teetotaller, abstainer, or nephalist.
A "dry drunk" is someone who abstains from alcohol but has a latent desire to resume drinking. They are not considered truly sober.
Sobriety is the achieved goal of independence from alcohol consumption. Sustained abstinence is a prerequisite for sobriety.
